In the latest bonus podcast, the practical use of intravenous immunoglobulin is discussed with perspectives from three continents. Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Dr. Lynette Kiers is a Clinical Associate Professor at The University of Melbourne, and Director of Clinical Neurophysiology at the Royal Melbourne Hospital, Australia. Dr. Christopher Hahn is an Associate Clinical...
Jul 11, 2025•39 min•Ep. 108
Gastric sleeve surgery is the key feature of a pair of recent cases from the journal, which start this episode (1:17). Both cases feature 25-yo women with presentations in common: paraesthesia and limb weakness, along with disordered eye movement. Their symptoms arose soon after the gastrectomy operation. https://pn.bmj.com/content/25/3/268 The second report is a "true grey case" (22:14), with a myriad of presenting symptoms in a 27-yo man: fevers, weight loss, lethargy, light sensitivity, and s...
Jun 27, 2025•42 min•Ep. 107
A neuroinflammatory disorder with the potential to affect virtually any organ in the body, IgG4-related disease is a challenge on many fronts. The latest Editors' Choice paper in the June 2025 issue takes on this systemic disease, presenting a treatment algorithm for its management. This episode, PN's podcast editor Dr. Amy Ross Russell speaks with author Dr. Claire Rice. Hear an overview on the disease background, the signs in presentation, what to look for in the histology, and steroid treatme...
Jun 06, 2025•33 min•Ep. 106
This episode’s theme is new diseases, whether they are newly described, or old diseases back in a new form. We start off with IgG4-related disease, a chronic multisystem disorder that is still being understood. Then there is a genetics paper on repeat expansion disorders, a group of conditions often thought as disparate but with quite a few commonalities. Next along is a fascinating case following gastric sleeve bariatric surgery, highlighting the dangers of travelling for unsupervised surgeries...
May 16, 2025•55 min•Ep. 105
Two wide open cases from the latest issue of the journal. Starting with a case from Italy (1:18), of a 63-yo man having a history of behavioural and cognitive problems since retiring. His many changes included low mood, significant weight loss, and problems with sleep and temperature regulation. He had a background of type 2 diabetes. Initial treatment was on a suspicion of Alzheimer's, but there was no clinical improvement. https://pn.bmj.com/content/25/2/159 A case from the United States is ne...
May 06, 2025•37 min•Ep. 104
Immune checkpoint inhibitors can significantly improve cancer survival rates. But resulting immune-related toxicities are common, requiring multidisciplinary cooperation between oncology and neurology. This episode, PN's podcast editor Dr. Amy Ross Russell speaks with a panel of experts on the balancing act required when treating cancer patients with these new drugs. Oncologist Dr. Heather Shaw¹ is alongside neurologists Dr. Aisling Carr² and Dr. Mark Willis³, and they are amongst the authors of...
Apr 17, 2025•58 min•Ep. 103
The latest guidelines on disease-modifying treatment in multiple sclerosis (MS) from the Association of British Neurologists is discussed in this intercontinental podcast with perspectives from the UK, the USA, and Australia. Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Dr. Tamara Kaplan is Assistant Professor of Neurology at Harvard Medical School, and is also affiliated with the Brigha...
Mar 26, 2025•36 min•Ep. 102
It's a podcast of pairs this time, for the latest issue of the journal. There's two hosts, two halves of the brain, two sides to a clinical debate, and two themes to the episode itself. Leading off is a discussion on peripheral neurology, taking a look at the editors' choice paper on immune checkpoint inhibitors. That's followed by a paper on secondary hypertension, and another on small fibre neuropathies. The second half covers elements of cognitive neurology, including a topic with increasing ...
Mar 14, 2025•43 min•Ep. 101
A puzzling pair of Case Reports from the most recent issue of the journal. First up (1:35) is a man in his mid-fifties, presenting with lumbar spine fractures, which then developed into confusion, vomiting, and abdominal pain. An x-ray showed dilated intestinal loops and his blood sodium levels were low. https://pn.bmj.com/content/25/1/87 The second case (23:06) involves a 21-yo woman, who presented at 18 weeks pregnant with multiple episodes of right upper limb tonic extension, and subsequently...
Mar 07, 2025•48 min•Ep. 100
Intermittent painful spasms, stiffness and rigidity of the proximal and truncal muscles are only a few symptoms of the relatively uncommon Stiff-person syndrome (SPS). In this podcast, we delve into the characteristics and diagnosis of this complex autoimmune condition. PN's podcast editor Dr. Amy Ross Russell interviews Professor Saiju Jacob (University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK). The paper is the Editor's Choice paper of the February issue of Practical Neurology...
Feb 22, 2025•42 min•Ep. 99
The practice of neurology is constantly changing, and the papers in this issue exemplify that trend. On this episode, journal editors Dr. Geraint Fuller and Prof. Philip Smith discuss their highlights from the latest issue of Practical Neurology, for February 2025. They begin with the editors' choice paper on stiff person syndrome, then speak about new guidance from the ABN on disease-modifying treatments for MS. There's also life-improving interventions for posterior cortical atrophy, changing ...
Jan 22, 2025•39 min•Ep. 98
Two more fascinating Case Reports from the latest issue of the journal. The first case (1:15) is of a 57-yo woman, with an intermittent posterior headache, which had an associated bilateral pressure-like sensation. Her symptoms had begun on a recent trip to Sri Lanka. https://pn.bmj.com/content/24/6/526 Following on is the second case (22:18), which features a 54-yo man experiencing deterioration in his speech and mobility. He had a background of chronic HIV infection with ongoing treatment. htt...
Jan 08, 2025•45 min•Ep. 97
It’s the Christmas Special for 2024! Joining Amy in the studio is Dr. Steven Lewis. Current secretary general of the World Federation of Neurology, Steven is based in the United States, where he works as a general neurologist. Their conversation builds on a recent article by Dr. Bas Bloem, " Islands and bridges in healthcare: the importance of general neurology ”. Listen in for insights on the differences in training and practice in the US and UK, the value of developing a network as a neurologi...
Dec 23, 2024•36 min•Ep. 96
The often challenging diagnosis of neuromuscular junction (NMJ) disorders can be explained by suspicious red flags for the key differential diagnoses (mimics) and atypical presentations (chameleons). In the latest Editor's Choice paper podcast, PN's podcast editor Dr. Amy Ross Russell interviews Dr Stephen Reddel and Dr Shadi El-Wahsh, both from the Concord Hospital, New South Wales, Australia, and the authors of Neuromuscular junction disorders: mimics and chameleons . Please subscribe to the P...
Dec 11, 2024•36 min•Ep. 95
Neuromuscular junction disorders can present in a variety of challenging ways, with the potential to mislead neurologists. Journal editors Prof. Philip Smith and Dr. Geraint Fuller begin with this subject as they talk through the latest issue of Practical Neurology, for December 2024. The conversation moves to neck flexion and brain zaps, reflects on the undiminished importance of "general" neurology, and also touches on maternal epilepsy risks, frailty's impact on stroke patients, timely recogn...
Nov 18, 2024•49 min•Ep. 94
The immune system is a recurring feature in the cases discussed in this edition of the Case Reports podcast. The first paper details the cases of two young women, sisters, presenting with overlapping conditions but resulting in tragically different outcomes (1:16). Both were in their twenties, had given birth recently, and developed limb weakness along with several other neurological symptoms. https://pn.bmj.com/content/24/5/422 Our second case is a 72-yo woman with a range of symptoms including...
Oct 31, 2024•36 min•Ep. 93
"Could this presenting syndrome be caused by a neurotoxin?" Oftentimes neurologists will pass over toxins when diagnosing. Yet disease caused by neurotoxins is widespread, with many having quite typical syndromes. In the studio to discuss this is the first author of the October 2024 Editors' Choice paper, Dr. Frederick Vonberg¹. He draws attention to some hobbies and occupations to watch out for, the global prevalence of lead poisoning, presentations of botulism, and the origin of the infamous M...
Oct 10, 2024•37 min•Ep. 92
The surgical sieve and Occam's razor may sound like familiar diagnostic metaphors, but what about Crabtree's bludgeon? These are just a few of the tools touched on by journal editors Prof. Philip Smith and Dr. Geraint Fuller, as they discuss the October 2024 issue of Practical Neurology. They cover recent publications on oligoclonal bands, neurotoxicology, methotrexate, carotid artery disease, epilepsy surgery, and how unsolved cases remain part of the "art of neurology". To finish, there is a c...
Sep 13, 2024•46 min•Ep. 91
This month's cases both feature sudden onset neurological syndromes. The first case (1:23) is that of a 26-yo Brazilian man who awoke from sleep with weakness in all four limbs. The signs suggest a possibility of Guillain-Barré syndrome or polio. A normal cranial nerve examination follows, with no unusual findings - https://pn.bmj.com/content/24/4/342 A 69-yo woman is the subject of the second case (14:33), after she presents with sudden onset unsteadiness and slurred speech when getting out of ...
Sep 04, 2024•33 min•Ep. 90
Genetic testing is a useful tool for any practising neurologist, but they must know how to interpret the results. This Editors' Choice podcast features two experts on the subject, Prof. Mary Reilly¹ and Dr. Christopher Record¹. They're in the studio to talk through their paper, covering the technology of genome sequencing itself, testing strategies, clinical use cases, and the constant changes in this developing field. Read the paper: Lessons and pitfalls of whole genome sequencing 1. Centre for...
Aug 19, 2024•38 min•Ep. 89
Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the August 2024 issue of Practical Neurology, with room for mystery, history and practical advice. In particular, they cover topics like whole genome sequencing, foot surgery for Charcot-Marie-Tooth disease, safe prescribing in steroids, and fertility treatment for the epileptic. There are also good reasons for dusting off the old optokinetic nystagmus drum, and a touching story of neuro palliative care. Read the Highlights - http...
Jul 24, 2024•42 min•Ep. 88
Two highly unusual cases in this edition of Case Reports. The first case describes a 64-yo woman presenting to the emergency department with a five day history of bizarre behaviours (1:45). A BBC radio show prompts her, out of character, to reflect aloud about her childhood, and she experiences recurrent periods of unresponsiveness followed by intense agitation. She was kept in hospital for scans and discharged after two weeks, but returned soon after with a similar presentation - ( link ) A lif...
Jul 15, 2024•41 min•Ep. 87
Neurodegenerative disease is the subject of this month's Editors' Choice podcast, with Dr. Patrick Cullinane¹ and Dr. Zane Jaunmuktane.¹ They join the podcast for an overview of brain examination, explaining the process of protein misfolding, the spread of pathology through the brain, and what new discoveries can tell us about old diseases. Read the paper: Pathology of neurodegenerative disease for the general neurologist 1. Queen Square Brain Bank for Neurological Disorders, UCL Queen Square In...
Jun 27, 2024•40 min•Ep. 86
Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the June 2024 issue of Practical Neurology, covering some of the interesting articles published this month. A number of difficult challenges and tradeoffs are featured, relating to recent men-only guidance for sodium valproate use, folic acid dosing for women with epilepsy, post-mortem brain donation, and sexual dysfunction caused by neurological medication. There is also some insight into the treatment of hepatic encephalopathy a...
May 30, 2024•42 min•Ep. 85
The first of this episode's two case reports features a 62-yo man, referred from ophthalmology with a drooping eyelid, chronic coughing, and excess sweating in the face provoked by eating (1:21). An MR scan finds abnormal deposits in his brain - ( link ) The second report describes two patients (17:05), firstly a 70-yo man presenting with abnormal facial movements and weight loss, and secondly a 90-yo woman with abnormal movements of her right arm and leg. Routine blood tests at presentation for...
May 14, 2024•34 min•Ep. 84
The first multidisciplinary consensus guideline for the diagnosis and treatment of spontaneous intracranial hypotension (SIH) has recently been published by the UK SIH Specialist Interest Group. Group members Prof. Manjit Matharu (1), Dr. Indran Davagnanam (2), and Mr. Parag Sayal (3) join Dr. Amy Ross Russell to explain their recommendations. They discuss the impact this condition has on patients, the possible presentations, and approaches for diagnosis and treatment. Read the article: Spontane...
Apr 23, 2024•42 min•Ep. 83
Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the April 2024 issue of Practical Neurology, covering some of the interesting articles published this month. Topics include inconsistencies observed in functional gait, the consequences of restrictive diets with reduced riboflavin, and a guideline to managing patients with spontaneous intracranial hypotension. In syndromic sightings there's a scattering of Ehlers-Danlos, Strachan and Alzheimer's to name but a few. Plus, some corre...
Mar 20, 2024•48 min•Ep. 82
The first case for this issue's discussion is one of a young man with a history of involuntary jerks and photosensitivity (1:20). Several more seizures followed his initial presentation with a general tonic-clonic seizure. A number of examinations were done including an MR scan and EEG - ( link ) Case two involves a 69-yo woman who developed non-convulsive status epilepticus, having been examined as a gastroenterology inpatient for abdominal pain (22:20). A positive PCR for Whipple’s disease in ...
Mar 06, 2024•45 min•Ep. 81
Neurophysiologists may "lock ourselves away in rooms looking at screens with wiggly lines on", but what are the applications in a clinical context for electroencephalography (EEG)? In this deep-dive episode, podcast editor Dr. Amy Ross Russell is joined by Dr. Nick Kane (1), an author of the Editors' Choice for the Feb 2024 issue, " Electroencephalography in encephalopathy and encephalitis ". They discuss the strategy of serial EEGs in epilepsy diagnosis, neuroinflammation in both autoimmune and...
Feb 16, 2024•43 min•Ep. 80
Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the February 2024 issue of Practical Neurology, covering some of the interesting articles published this month. The papers discussed touch on the use of electroencephalography (EEG) for encephalopathies, neurologists' role in the integration of cognitive behavioural therapy (CBT) in treatment, key signs to look for in walking patients, and how rising temperatures due to climate change may affect our brains. The final topic of conv...
Jan 23, 2024•42 min•Ep. 79
